Objective·To explore the effects and potential mechanisms of emodin on Alzheimer's disease(AD).Methods·Wild-type C57BL/6J mice and 3×Tg-AD mice were divided into 6 groups:Control group(C57BL/6J mice),AD group(3×Tg-AD mice),Emodin 25 mg/kg group(3×Tg-AD mice+Emodin 25 mg/kg),Emodin 50 mg/kg group(3×Tg-AD mice+Emodin 50 mg/kg),Emodin 100 mg/kg group(3×Tg-AD mice+Emodin 100 mg/kg)and Donepezil group(3×Tg-AD mice+Donepezil 3 mg/kg).The Morris water maze test was used to evaluate the learning and memory abilities of mice.The expression of glial fibrillary acidic protein(GFAP),glucose-regulated protein 78kDa(GRP78),and inositol-requiring enzyme 1α(IRE1α)was detected by immunohistochemistry.The levels of tumor necrosis factor-α(TNF-α),interleukin-1β(IL-1β),and IL-6 in brain tissue were measured by enzyme-linked immunosorbent assay(ELISA).Western blotting was used to detect the expression of NF-κB p65,p-NF-κB p65,p38,and p-p38 proteins.Results·Compared with the control group,mice in the AD group showed impaired cognition,increased GFAP expression,elevated levels of TNF-α,IL-1β and IL-6,and increased expression of GRP78 and IRE1α,along with enhanced phosphorylation of NF-κB p65 and p38.Compared with the AD group,emodin improved cognitive impairment of AD mice,inhibited astrocyte overactivation and neuroinflammation,and decreased the expression of GRP78,IRE1α,phosphorylated NF-κB p65,and phosphorylated p38 in brain tissue.Conclusion·Emodin can effectively improve cognitive impairment in AD mice,which may be related to the inhibition of endoplasmic reticulum stress-mediated neuroinflammation in astrocytes.

Objective:To investigate the prevalence of and risk factors associated with Neisseria gonorrhoeae (NG), Chlamydia trachomatis (CT) and high-risk human papillomavirus (HPV) coinfections among patients with newly diagnosed syphilis at a hospital in Nanjing. Methods:A cross-sectional study was conducted on patients with newly diagnosed syphilis at the STD Clinic, Hospital of Dermatology, Chinese Academy of Medical Sciences in Nanjing, China from May 2023 to April 2024. Urethral, cervical or rectal swabs were collected according to the gender and types of sexual behavior of the patients. Screening tests for CT, NG and HPV infections were then performed by nucleic acid amplification testing. High-risk HPV testing was performed only in female patients. Univariate analysis was carried out to investigate risk factors associated with CT infection. The chi-square test, chi-square test with continuity correction, or Fisher's exact test was chosen based on the sample size and expected values.Results:A total of 111 newly diagnosed syphilis patients with test specimens were collected, including 71 males (64%) and 40 females (36%), and their ages ranged from 16 to 87 years; there were 82 patients with early syphilis and 29 with late latent syphilis; the number of sexual partners in the past 3 months ranged from 0 to 3. Among the 60 male patients with early syphilis, 1 (1.7%) was co-infected with NG, and 12 (20%) with CT; among the 16 men who have sex with men, 7 (43.8%) were co-infected with CT, while 5 (11.4%) of the 44 heterosexual patients were co-infected with CT, showing a significant difference in CT infection rates between the two groups ( χ2 = 5.80, P = 0.016). Among the 22 female patients with early syphilis, 1 (4.5%) was co-infected with NG, and 8 (36.4%) with CT; among the 12 female patients aged < 25 years, 8 (66.7%) were infected with CT, while none of the 7 patients aged 25-44 years or the 3 patients aged ≥ 45 years were infected with CT, showing a significant difference in CT infection rates among the 3 age groups ( P = 0.005) ; among the 16 female patients with 1 sexual partner in the past 3 months, 3 were infected with CT, while 5 were infected with CT in the 6 female patients with 2-3 sexual partners in the past 3 months, with a significant difference in CT infection rates between the two groups ( P = 0.011). Out of the 40 female patients with syphilis, 16 (40%) were co-infected with high-risk HPV; the HPV infection rates did not differ among different age groups (age groups of < 25 years, 25-44 years, ≥ 45 years: 8/14, 2/9, 6/17, respectively; P = 0.265) . Conclusion:The CT infection rate was relatively high in patients with newly diagnosed early syphilis, and a relatively high infection rate of high-risk HPV was observed in female patients with syphilis aged < 25 years.

Objective:To investigate the prevalence of and risk factors associated with Neisseria gonorrhoeae (NG), Chlamydia trachomatis (CT) and high-risk human papillomavirus (HPV) coinfections among patients with newly diagnosed syphilis at a hospital in Nanjing. Methods:A cross-sectional study was conducted on patients with newly diagnosed syphilis at the STD Clinic, Hospital of Dermatology, Chinese Academy of Medical Sciences in Nanjing, China from May 2023 to April 2024. Urethral, cervical or rectal swabs were collected according to the gender and types of sexual behavior of the patients. Screening tests for CT, NG and HPV infections were then performed by nucleic acid amplification testing. High-risk HPV testing was performed only in female patients. Univariate analysis was carried out to investigate risk factors associated with CT infection. The chi-square test, chi-square test with continuity correction, or Fisher's exact test was chosen based on the sample size and expected values.Results:A total of 111 newly diagnosed syphilis patients with test specimens were collected, including 71 males (64%) and 40 females (36%), and their ages ranged from 16 to 87 years; there were 82 patients with early syphilis and 29 with late latent syphilis; the number of sexual partners in the past 3 months ranged from 0 to 3. Among the 60 male patients with early syphilis, 1 (1.7%) was co-infected with NG, and 12 (20%) with CT; among the 16 men who have sex with men, 7 (43.8%) were co-infected with CT, while 5 (11.4%) of the 44 heterosexual patients were co-infected with CT, showing a significant difference in CT infection rates between the two groups ( χ2 = 5.80, P = 0.016). Among the 22 female patients with early syphilis, 1 (4.5%) was co-infected with NG, and 8 (36.4%) with CT; among the 12 female patients aged < 25 years, 8 (66.7%) were infected with CT, while none of the 7 patients aged 25-44 years or the 3 patients aged ≥ 45 years were infected with CT, showing a significant difference in CT infection rates among the 3 age groups ( P = 0.005) ; among the 16 female patients with 1 sexual partner in the past 3 months, 3 were infected with CT, while 5 were infected with CT in the 6 female patients with 2-3 sexual partners in the past 3 months, with a significant difference in CT infection rates between the two groups ( P = 0.011). Out of the 40 female patients with syphilis, 16 (40%) were co-infected with high-risk HPV; the HPV infection rates did not differ among different age groups (age groups of < 25 years, 25-44 years, ≥ 45 years: 8/14, 2/9, 6/17, respectively; P = 0.265) . Conclusion:The CT infection rate was relatively high in patients with newly diagnosed early syphilis, and a relatively high infection rate of high-risk HPV was observed in female patients with syphilis aged < 25 years.

Objective·To explore the effects and potential mechanisms of emodin on Alzheimer's disease(AD).Methods·Wild-type C57BL/6J mice and 3×Tg-AD mice were divided into 6 groups:Control group(C57BL/6J mice),AD group(3×Tg-AD mice),Emodin 25 mg/kg group(3×Tg-AD mice+Emodin 25 mg/kg),Emodin 50 mg/kg group(3×Tg-AD mice+Emodin 50 mg/kg),Emodin 100 mg/kg group(3×Tg-AD mice+Emodin 100 mg/kg)and Donepezil group(3×Tg-AD mice+Donepezil 3 mg/kg).The Morris water maze test was used to evaluate the learning and memory abilities of mice.The expression of glial fibrillary acidic protein(GFAP),glucose-regulated protein 78kDa(GRP78),and inositol-requiring enzyme 1α(IRE1α)was detected by immunohistochemistry.The levels of tumor necrosis factor-α(TNF-α),interleukin-1β(IL-1β),and IL-6 in brain tissue were measured by enzyme-linked immunosorbent assay(ELISA).Western blotting was used to detect the expression of NF-κB p65,p-NF-κB p65,p38,and p-p38 proteins.Results·Compared with the control group,mice in the AD group showed impaired cognition,increased GFAP expression,elevated levels of TNF-α,IL-1β and IL-6,and increased expression of GRP78 and IRE1α,along with enhanced phosphorylation of NF-κB p65 and p38.Compared with the AD group,emodin improved cognitive impairment of AD mice,inhibited astrocyte overactivation and neuroinflammation,and decreased the expression of GRP78,IRE1α,phosphorylated NF-κB p65,and phosphorylated p38 in brain tissue.Conclusion·Emodin can effectively improve cognitive impairment in AD mice,which may be related to the inhibition of endoplasmic reticulum stress-mediated neuroinflammation in astrocytes.

Objective:To investigate the effects and mechanisms of zinc ion-loaded composite hydrogel (hereinafter referred to as the zinc-containing hydrogel) on infected full-thickness skin defect wounds in diabetic mice.Methods:This study was an experimental study. A poly (glycerol sebacate)-co-poly(ethylene glycol)-g-catechol prepolymer/quaternized-chitosan hydrogel (hereinafter referred to as the simple hydrogel) and a solid-state zinc-containing hydrogel with porous and good adhesion by adding zinc ions to the simple hydrogel were prepared. The release rate of zinc ions from the zinc-containing hydrogel after immersion in phosphate buffer solution (PBS) for 14 days was calculated. The concentration of methicillin-resistant Staphylococcus aureus (MRSA) cultured for 2 hours with the simple hydrogel, zinc-containing hydrogel, and PBS was measured. The scavenging ability of the simple hydrogel, zinc-containing hydrogel, and PBS for 1,1-diphenyl-2-picrylhydrazyl radical 2,2-diphenyl-1-(2, 4, 6-trinitrophenyl) hydrazyl (DPPH) was detected using microplate reader to reflect the ability of oxygen free radical removal. The length of vessels formed by human umbilical vein endothelial cells (HUVECs) cultured for 24 hours with the simple hydrogel, zinc-containing hydrogel, and PBS was measured. The cell viability of L929 cells cultured for 24 hours with the simple hydrogel, zinc-containing hydrogel, and PBS was detected using the cell counting kit-8. The mouse red blood cell suspension was divided into blank control group treated with PBS, simple hydrogel group, zinc-containing hydrogel group, and Triton X-100 group treated with corresponding solution. Hemolysis was detected using microplate reader after 2 hours of treatment, and the hemolysis rate was calculated. All experiments had a sample size of 3. Twenty-one C57BL/6J mice aged 6-8 weeks were taken, and a full-thickness skin defect wound was prepared in the symmetrical position on the back spine and infected with MRSA. Mice were divided into blank control group treated with PBS, simple hydrogel group, and zinc-containing hydrogel group treated with the corresponding hydrogel. Three days after injury, bacterial concentration in the wounds were measured in all groups of mice ( n=4). On day 0 (immediately), 3, 7, and 14 after injury, the wound infection status of mice was generally observed and the wound healing rate was calculated ( n=5). Hematoxylin-eosin staining and Masson staining were used to detect new epithelium and collagen formation in the wounds of mice on day 14 after injury. Immunofluorescence staining was used to detect neovascularization and distribution of M2 macrophages in the wounds of mice. Results:After immersion for 14 days, the release rate of zinc ions of the zinc-containing hydrogel was (70.5±4.6)%. Compared with the zinc-containing hydrogel, the bacterial concentration was significantly increased after 2 hours of culture with PBS and the simple hydrogel ( P<0.05). The DPPH scavenging rate of the zinc-containing hydrogel was significantly higher than that of PBS and the simple hydrogel (with P values all <0.05). The length of vessels formed by HUVECs cultured for 24 hours with the zinc-containing hydrogel was significantly longer than that cultured with PBS ( P<0.05). Compared with PBS and the simple hydrogel, the cell viability of L929 cells cultured for 24 hours with the zinc-containing hydrogel was significantly higher ( P<0.05). After 2 hours of incubation, compared with that in Triton X-100 group, the hemolysis rate of red blood cells in blank control, simple hydrogel, and zinc-containing hydrogel groups was significantly reduced ( P<0.05); and the hemolysis rate of red blood cells in the latter three groups was similar ( P>0.05). On day 3 after injury, the bacterial concentration in the wounds of mice in zinc-containing hydrogel group was significantly lower than that in blank control and simple hydrogel groups (with P values all <0.05). From day 3 to day 14 after injury, the wounds of mice in all the three groups were gradually healing, and on day 14 after injury, the wounds of mice in the zinc-containing hydrogel group were basically healed. On day 7 after injury, the wound healing rate of mice in zinc-containing hydrogel group was (72.4±8.4)%, which was significantly higher than that of blank control and simple hydrogel groups, being (31.6±6.7)% and (44.7±5.4)%, respectively(with P values all< 0.05). On day 14 after injury, the wound healing rate of mice in zinc-containing hydrogel group was (92.7±4.3)%, which was significantly higher than (73.5±7.4)% in blank control group ( P<0.05). On day 14 after injury, compared with that in blank control and simple hydrogel groups, the newly formed epidermis in mice wound of zinc-containing hydrogel group was longer and thicker, with more collagen deposition, and a more abundant distribution of new vessels and M2 macrophages. Conclusions:The zinc-containing hydrogel exhibits good biocompatibility, oxygen free radical scavenging capacity, and antimicrobial effects both in vitro and in vivo, as well as angiogenic promotion capability. It can provide sustained release of zinc ions to promote re-epithelialization and collagen synthesis, thus enhancing the healing of infected full-thickness skin defect wounds in diabetic mice.

Objective:To access the effectiveness and safety of the intrauterine balloon tamponade verse gauze packing combined with temporary abdominal aortic balloon occlusion in the management of placenta accreta spectrum (PAS).Methods:This was an open-label, randomized controlled trial conducted in Nanjing Drum Tower Hospital. The patients suspected with PAS for uterine preservation surgery under the multidisciplinary team care were recruited between Aug 2015 and Jan 2018. When bleeding could not be achieved after fetus delivered, and a temporary abdominal aortic balloon occlusion and the compression sutures as needed, the women were randomly allocated 1∶1 into balloon tamponade ( n=81) or gauze packing ( n=80) group. The primary outcome was successful bleeding arrests by avoiding second line surgeries. The secondary outcomes included the volume of blood loss during and after cesarean section, the rate of PPH, incidence and amount of blood transfusion, hysterectomy, postpartum pain, ICU admission, need for re-laparotomy, and the length of hospital stay, readmission, and interventional radiology complications. Results:All the women [100% (81/81)] in the balloon group were obtained hemostasis without further intervention, significantly higher than 88% (70/80) in the gauze group ( P=0.001). Before uterine tamponade, blood loss were 820 ml (620-1 230) ml and 850 ml (605-1 442) ml, while placenta bed were sutured in 96%（78/81, 77/80） respectively ( P>0.05).The proportion of blood loss≥1 000 ml was higher in the gauze group than that in the balloon group ( P=0.006). Maternal adverse events involving total blood loss, puerperal morbidity and postpartum pain occurred more frequently in the gauze group ( P<0.05). The following outcome showed no statistically significant difference between the two groups: the vascular occlusion time, the dose of radiation, and interventional radiology complication ( P>0.05). The median volume infused into the lower and upper balloons is 70 ml (50-100 ml) and 180 ml (100-240 ml). Conclusions:Incrauterine balloon tamponade is as effective as gauze packing in hemostasis following the placenta delivery in PAS. Compared with gauze packing, the uterine balloon tamponade is more effective.

Macrophages play critical roles in renal fibrosis. However, macrophages exhibit ontogenic and functional heterogeneities, and which population of macrophages contributes to renal fibrosis and the underlying mechanisms remain unclear. In this study, we genetically targeted Notch signaling by disrupting the transcription factor recombination signal binding protein-Jκ (RBP-J), to reveal its role in regulation of macrophages during the unilateral ureteral obstruction (UUO)-induced murine renal fibrosis. Myeloid-specific disruption of RBP-J attenuated renal fibrosis with reduced extracellular matrix deposition and myofibroblast activation, as well as attenuated epithelial-mesenchymal transition, likely owing to the reduced expression of TGF-β. Meanwhile, RBP-J deletion significantly hampered macrophage infiltration and activation in fibrotic kidney, although their proliferation appeared unaltered. By using macrophage clearance experiment, we found that kidney resident macrophages made negligible contribution, but bone marrow (BM)-derived macrophages played a major role in renal fibrogenesis. Further mechanistic analyses showed that Notch blockade reduced monocyte emigration from BM by down-regulating CCR2 expression. Finally, we found that myeloid-specific Notch activation aggravated renal fibrosis, which was mediated by CCR2 macrophages infiltration. In summary, our data have unveiled that myeloid-specific targeting of Notch could ameliorate renal fibrosis by regulating BM-derived macrophages recruitment and activation, providing a novel strategy for intervention of this disease.

Objective To evaluate the value of 18 F?NaF PET/CT and MRI in the diagnosis of skull?base bone invasion ( SBBI) in patients with nasopharyngeal carcinoma( NPC) . Methods Sixty?three NPC patients (45 males, 18 females;age range 23-72 years) were enrolled in this prospective study. Pa?tients underwent 18 F?NaF PET/CT and MRI to confirm whether the skull base was invaded. The reference standard was based on the follow?up imaging in 6 months. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of the two imaging modalities were calculated. χ2 test was used to analyze their difference. The SBBI foci and their distribution detected by the two imaging modalities were compared. Results Thirty?four NPC patients demonstrated SBBI in follow?up imaging. The diagnostic sen?sitivity, specificity, positive predictive value, negative predictive value, and accuracy of 18 F?NaF PET/CT were 97.1%(33/34), 89.7%(26/29), 91.7%(33/36), 96.3%(26/27) and 93.7%(59/63), respective?ly. For MRI, the parameters were 91.2%(31/34), 86.2%(25/29), 88.6%(31/35), 89.3%(25/28) and 88.9%(56/63), respectively. The diagnostic efficiency of the two imaging modalities had no significant difference (χ2=0.162-1.062, all P>0.05) . 18 F?NaF PET/CT detected 133 lesions and MRI detected 97 le? sions, and the clivus was the most common site of SBBI. Conclusions 18 F?NaF PET/CT and MRI have similar diagnostic efficiency in detecting SBBI. 18 F?NaF PET/CT can detect more lesions than MRI do, and has potential advantage for detecting tiny bone lesions in skull base.

Objective:To explore the feasibility of screening for major fetal heart disease by training sonographers in township or county level hospitals .Methods:Training of B ultrasound scan for congeni-tal heart defects was given to the sonographers from one county hospital , and thirteen township hospitals ( or the district hospitals ) , and training of fetal echocardiography was given to sonographers from four city/county hospitals.The trained sonographers who had passed the examinations and had obtained quali-fications after six months of independent practice began to screen fetal congenital heart defects .To evalu-ate the effectiveness , sensitivity and specificity of screening was calculated by using the diagnosis of ex-pert neonatal/fetal echocardiographers as the gold standard .Results: A total of 3 425 fetuses received one fetal B ultrasound screening , one fetal echocardiography and one neonatal echocardiography from April 1, 2004 to December 31, 2005.One hundred and sixty-five B ultrasound screening images (4.9%) from township hospitals and fifty-six fetal echocardiography images (1.7%) from county or city centers couldn ’ t be reviewed because of poor quality .The sensitivity of fetal B ultrasound screening in the township and county hospitals was 30%and 0, and the specificity 93.3%and 99.9%, respectively. Nine fetuses with a major congenital heart disease were eventually found by the trained sonographers , and two cases were misdiagnosed and two unnoticed .The total sensitivity and specificity of fetal echocardio-graphy were 81.8% and 99.9%, respectively.The sensitivity in the county and city hospitals was 66 .7% and 100%, respectively .The specificity in the county and city hospitals was 99 .9%and 100%, respectively .Conclusion: Under the current circumstances , township hospitals are unable to perform effective fetal cardiac screening .Screening on fetal congenital heart disease is suggested to be taken by trained sonographers in county and city level medical centers .

To discuss the value of the diagnosis and treatment for the submucous myomas by hysteroscope. According to the data of hysteroscopic resection in the treatment of submucous fibroids, the authors suggested that the submucous myomas should be divided into four types and the detailed appearance of each type were discussed. Conclusions: Four types of the submucous myomas were distinguished and the surgical treatment of each type were chosen correspondingly under hysteroscope.